The Importance of Maintaining Healthy Nitric Oxide Levels

The health benefits of building and maintaining healthy tissue levels of nitric oxide cannot be overstated, especially today with advancing mitochondrial insufficiency and metabolic dysfunction among the general population. Our modern diet of ultra-processed, industrialized food deficient in the functional nutrients of life, combined with chronic stress, a sedentary lifestyle, and multiple insults from environmental toxins, has reduced our ability to produce healthy levels of this critical signaling molecule. Interference with normal nitric oxide production can have significant impacts on health, contributing to conditions such as hypertension, cardiovascular disease, diabetes, and more. Maintaining a healthy lifestyle, including a balanced diet rich in antioxidants and nitrates, regular physical activity, and avoiding smoking and excessive pollution exposure, can help support normal NO production and its beneficial effects on the body.

Medical science has been reporting on nitric oxide since 1998, when three scientists were awarded the Nobel Prize for their discovery that nitric oxide is a critical molecule in the cardiovascular system that helps keep blood vessels healthy and regulates blood pressure. In 1992, nitric oxide was named “molecule of the year” because of its importance in human health. This interest led to a resurgence of research on nitric oxide, which has identified wide-ranging effects on immune, neurological, metabolic, sexual, and respiratory health. Its ability to regulate blood flow, immune responses, neurotransmission, and more underscores its importance in maintaining overall health and preventing various diseases.

In simple terms, the Nitric oxide (NO) molecule consists of one nitrogen atom and one oxygen atom. It’s produced in various tissues and cells throughout the body, including the vascular endothelium, where nitric oxide is produced from the amino acid L-arginine, facilitated by the enzyme nitric oxide synthase (NOS). It is also produced in brain and peripheral nervous system neurons, macrophages and other immune cells, and liver hepatocytes.

It’s important to note that our diet and lifestyle choices can significantly influence nitric oxide production in our bodies. A deficiency in nitric oxide production and activity is directly linked to metabolic dysfunction and insulin resistance, which currently affect 88% of the US population. The prevalence of chronic diseases, coupled with a Standard American Diet (SAD) that lacks whole, fresh, nutrient-dense foods, has led to a shortage in the necessary nutritional co-factors for nitric oxide production.  Here are some key factors that can disrupt NO production:

  • Oxidative stress– chronic inflammation, exposure to pollutants, and certain diseases, such as diabetes, vascular disease, hypertension, kidney disease, and neurodegeneration, combined with a lack of antioxidants like vitamins C and E can reduce NO availability.
  • Poor diet/dietary deficiencies– L-arginine is a precursor for NO synthesis. Insufficient intake of this amino acid can limit NO production. L-arginine is found in high-quality animal protein, nuts and seeds, legumes, and dairy products. Dietary nitrates and nitrites, found in vegetables like spinach and beets, are converted to NO in the body. A diet lacking these nutrients can reduce NO levels. Also, diets high in unhealthy fats and sugars can impair endothelial function and reduce NO production.
  • Sedentary lifestyle– Regular physical activity stimulates NO production. A sedentary lifestyle can lead to reduced NO levels and associated health problems like hypertension and endothelial dysfunction.
  • Medications– Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can interfere with NO production by affecting endothelial function or increasing oxidative stress.
  • Environmental factors– Exposure to environmental pollutants like heavy metals and particulate matter can impair NO production by increasing oxidative stress and damaging endothelial cells.

Fortunately, rebuilding and maintaining healthy levels of nitric oxide can be as simple as making better diet and lifestyle choices. Several nutritional substances can help the body produce nitric oxide (NO) by providing the necessary precursors and cofactors for its synthesis or by promoting the activity of nitric oxide synthase (NOS) enzymes. Here are some essential nutrients that support NO production:

  1. L-Arginine
  • Role: L-arginine is a direct precursor to nitric oxide. NOS enzymes convert L-arginine into NO and L-citrulline.
  • Sources: Meat, poultry, fish, dairy products, nuts, seeds, legumes, and whole grains.
  1. L-Citrulline
  • Role: L-citrulline is converted into L-arginine in the kidneys, which can then be used to produce NO. Supplementing with L-citrulline can increase L-arginine levels more effectively than L-arginine itself.
  • Sources: Watermelon, cucumbers, and other melons.
  1. Nitrates
  • Role: Dietary nitrates are converted into nitrites by bacteria in the mouth and further reduced to nitric oxide in the body. This pathway is particularly important when oxygen levels are low.
  • Sources: Leafy greens (such as spinach, arugula, and lettuce), beets, celery, and other nitrate-rich vegetables.
  1. Antioxidants
  • Role: Antioxidants protect nitric oxide from oxidative degradation and support endothelial function, enhancing NO production.
  • Sources:
    • Vitamin C: Citrus fruits, strawberries, bell peppers, broccoli, and Brussels sprouts.
    • Vitamin E: Nuts, seeds, spinach, and vegetable oils.
    • Polyphenols: Fruits (such as berries and grapes), tea, dark chocolate, and red wine.
  1. Folate (Vitamin B9)
  • Role: Folate supports the production of tetrahydrobiopterin (BH4), a cofactor for NOS enzymes essential for NO synthesis.
  • Sources: Leafy greens, legumes, citrus fruits, and fortified cereals.
  1. Coenzyme Q10 (CoQ10)
  • Role: CoQ10 helps maintain endothelial function and can enhance NO production by reducing oxidative stress.
  • Sources: Meat, poultry, fish, nuts, and seeds.
  1. Omega-3 Fatty Acids
  • Role: Omega-3 fatty acids support endothelial function and can increase NO production.
  • Sources: Fatty fish (such as salmon, mackerel, and sardines), flaxseeds, chia seeds, and walnuts.
  1. Magnesium
  • Role: Magnesium supports endothelial function and helps in the relaxation of blood vessels, indirectly promoting NO production.
  • Sources: Nuts, seeds, whole grains, leafy green vegetables, and legumes.
  1. Resveratrol
  • Role: Resveratrol, a polyphenol found in red wine and certain fruits, can enhance NO production by activating the enzyme endothelial nitric oxide synthase (eNOS).
  • Sources: Red grapes, red wine, blueberries, and peanuts.
  1. Probiotics
  • Role: Probiotics can enhance the conversion of dietary nitrates to nitrites in the mouth and gut, promoting NO production.
  • Sources: Yogurt, kefir, sauerkraut, kimchi, and other fermented foods.

Incorporating these nutrients into your diet can support the body’s ability to produce nitric oxide, promoting cardiovascular health, improved blood flow, and overall well-being. A balanced diet rich in these substances, combined with a healthy lifestyle, can optimize NO levels and its beneficial effects.


Michael Chase, MS, NTP
Nutrition Science and Dietetics


DISCLAIMER: The information provided in this post is for educational purposes only, and should not be construed as personal medical advice or instruction. No action should be taken based solely on the contents of this information. Individuals should consult appropriate health professionals on any matter relating to their health and well-being. The statements made in this informational document have not been evaluated by the Food and Drug Administration. Any product discussed is not intended to diagnose, treat, cure or prevent any disease.

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